Long-term objectives of the proposed research study include (a) to build a research program that systematically investigates the processes and outcomes of community-based nurse managed practice, and (b) to apply findings toward the development and dissemination of an exemplary praxis model of community-based nurse-managed practice. The overall research question is: What are the factors that facilitate the establishment, diffusion, and sustainability of community-based nurse-managed practice? This question will be addressed through three cases of nurse-managed practice: urban academic, urban nonacademic, and rural nonacademic. The specific alms are: (a) to describe the evolution of the development and integration of three nurse-managed practices within their community context; (b) to identify how managers and clinicians of nurse-managed practices facilitated their acceptance in their particular community context; (c) to describe how perceptions of nursing held by the local public and by other health care providers facilitated the nurse-n practices to embed in the community; (d) to describe what managers and clinicians of nurse-managed practices perceive as critical to their sustainability and continued acceptance by the community; and (e) to examine context as it relates to variations in establishing, diffusing, and sustaining community-based nurse-managed practice. The research design of embedded multiple-case study was selected to retain the holistic and meaningful characteristics of real-life events, to permit comparative analyses, and to accommodate multiple sources of quantitative and qualitative data, including documents, artifacts, interviews, and observations, as well as multiple units of analysis.